647 research outputs found
Design to reliability shielded vertical interconnection applied to microwave Chip Scale Packaging
This paper presents the electrical design, measurement and reliability ests of a shielded vertical interconnection dedicated to microwave solder-mount packages. Electromagnetic simulations show very good results up to 20 GHz. Test samples have been designed and manufactured. Electrical results are in accordance with the simulations with insertion loss lower than 0.1 dB up to 20 GHz for the proposed interconnection. Reliability tests of present no degradation of the after 500 thermal cycles in the [-55°C, +125°C] temperature range
A systematic review of cost-effectiveness analyses of complex wound interventions reveals optimal treatments for specific wound types.
BackgroundComplex wounds present a substantial economic burden on healthcare systems, costing billions of dollars annually in North America alone. The prevalence of complex wounds is a significant patient and societal healthcare concern and cost-effective wound care management remains unclear. This article summarizes the cost-effectiveness of interventions for complex wound care through a systematic review of the evidence base.MethodsWe searched multiple databases (MEDLINE, EMBASE, Cochrane Library) for cost-effectiveness studies that examined adults treated for complex wounds. Two reviewers independently screened the literature, abstracted data from full-text articles, and assessed methodological quality using the Drummond 10-item methodological quality tool. Incremental cost-effectiveness ratios were reported, or, if not reported, calculated and converted to United States Dollars for the year 2013.ResultsOverall, 59 cost-effectiveness analyses were included; 71% (42 out of 59) of the included studies scored 8 or more points on the Drummond 10-item checklist tool. Based on these, 22 interventions were found to be more effective and less costly (i.e., dominant) compared to the study comparators: 9 for diabetic ulcers, 8 for venous ulcers, 3 for pressure ulcers, 1 for mixed venous and venous/arterial ulcers, and 1 for mixed complex wound types.ConclusionsOur results can be used by decision-makers in maximizing the deployment of clinically effective and resource efficient wound care interventions. Our analysis also highlights specific treatments that are not cost-effective, thereby indicating areas of resource savings. Please see related article: http://dx.doi.org/10.1186/s12916-015-0288-5
Biochemical and Fatty Acids Composition of Water Buffalo (Bubalus Bubalis) Follicular Fluid
Aim of this study was to characterize the biochemical and fatty acids composition of follicular fluid collected from follicles of different sizes and in different phases of ovarian cycle in water buffalo farmed in Italy. Ovaries were collected at slaughterhouse during the breeding season; follicular fluid was aspirated dividing samples in small and large follicles (< 6 mm and > 6 mm respectively) and in luteal and follicular phase. Biochemical analysis and gas-chromatography were performed. Biochemical and fatty acids composition were greatly influenced by both follicular dimension and phase of ovarian cycle. Biochemical composition and its variations were in agreement with previously study conducted in buffalo and other species. This is the first report of the fatty acids composition of buffalo follicular fluid. Twenty-two fatty acids were identified in follicular fluid; nine were saturated fatty acids, six monounsatured fatty acids and seven polyunsatured fatty acids. The most dominant fatty acids were linoleic acid, oleic acid, palmitic acid, stearic acid and arachidonic acid. All the identified fatty acids concentrations vary at least because of follicle dimension or phase, with the exception of γ-linoleic acid and arachidonic acid which concentrations remain stable in all classes
Stuck Outside and Inside: An Exploratory Study on the Effects of the COVID-19 Outbreak on Italian Parents and Children\u2019s Internalizing Symptoms
The Covid-19 outbreak and the subsequent lockdown have profoundly impacted families\u2019 daily life, challenging their psychological resilience. Our study aimed to investigate the immediate psychological consequences of the pandemic on Italian parents and children focusing on internalizing and post-traumatic symptoms. We also wanted to explore the impact of possible risk and resilience factors, e.g., lifestyle and behaviors, emotional and cognitive beliefs, on parents and children\u2019s reaction to the emergency distress. An online survey was administered during the country\u2019s nationwide lockdown to 721 Italian parents of at least one child aged between 6 and 18 years. The respondent completed the survey for himself/herself and his/her child. The survey included socio-demographic items and validated questionnaires on parents\u2019 post-traumatic stress symptoms, depression and anxiety levels, and on children\u2019s internalizing problems. Parents were asked to fill the questionnaires twice: once referring to the current emergency condition and once recalling how they and their child felt a few months before Covid-19 outbreak. Multiple regression analyses showed that specific demographic characteristics (i.e., sex and age) and psychological factors of children and parents, such as fear of contagion and the opportunity to think about possible secondary positive effects of the pandemic, had a predictive value on the presence of internalizing symptoms of both parents and children. Moreover, parents\u2019 behaviors during the lockdown period (i.e., employment status and sport practiced) were significantly related to their own internalizing symptoms; these symptoms, in turn, had a strong and positive predictive value on children\u2019s internalizing problems. Besides, analyses of variance showed that internalizing symptoms of parents and children were significantly higher during the Covid-19 pandemic than before it started. In addition to showing a direct effect of the pandemic on the psychological health of parents and children, the present results also give a series of important information on how parents perceive, and therefore influence, their children in this period of emergency. Our findings thus highlight the urgent need to provide parents with adequate support to take care of their own psychological wellbeing and to help their children coping with the direct and indirect effects of the pandemic
Bothrops jararacussu venom-induced neuromuscular blockade inhibited by Casearia gossypiosperma Briquet hydroalcoholic extract
CNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOFAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOThe hydroalcoholic extract of Casearia gossypiosperma Briquet (Flacourtiaceae) was standardized for the first time through quality control procedures including pharmacognostic methods, fingerprint chromatograms, defined amounts of marker substances and physicochemical characteristics. The pharmacological activity of C. gossypiosperma (Cg) hydroalcoholic extract was assayed by a traditional in vitro test, which involved irreversible neuromuscular blockade induced by Bothrops jararacussu (Bjssu) venom (60 mu g/mL) in mouse phrenic nerve-diaphragm preparations. Bjssu venom blocked muscle activity for 26 (+/- 2.0) minutes (n = 6). Cg extract (0.1 mg/mL) induced changes on the baseline muscle activity without impairing the muscle function and inhibited 87.6% (+/- 1.8) (n = 6) of the Bjssu venom-induced blockade. Both flavonoids (0.624 g%) and polyphenols (4.63 g%) from the extract were spectrophotometrically quantified. Therefore, the present study confirms the antibothropic activity of Cg extract, supporting the ethnomedical use of Casearia sp. in the treatment of snakebite victims163432441CNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOFAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOFAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOsem informaçãosem informaçã
Vellozia flavicans Mart. ex Schult. hydroalcoholic extract inhibits the neuromuscular blockade induced by Bothrops jararacussu venom
FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOBackground: Snakebite is a significant public health issue in tropical countries. In Brazil, some of the most common snake envenomations are from Bothrops. Bothrops bites trigger local and systemic effects including edema, pain, erythema, cyanosis, infections, and necrosis. Vellozia flavicans is a plant from the Brazilian " cerrado" (savanna) that is popularly used as an anti-inflammatory medicine. Since inflammation develops quickly after Bothrops bites, which can lead to infection, the aim of the present study was to observe possible anti-snake venom and antimicrobial activities of V. flavicans (Vf). Methods: The chromatographic profile of the main constituents from the Vf leaf hydroalcoholic extract was obtained by thin-layer chromatography (TLC). The anti-snake venom activity was measured by Vf's ability to neutralize the in vitro neuromuscular blockade caused by Bothrops jararacussu venom (Bjssu) in a mouse phrenic nerve-diaphragm model (PND). After a 20 min incubation, preparations of PND were added to Tyrode's solution (control); Vf (0.2, 0.5, 1, and 2 mg/mL); 40 μg/mL Bjssu; pre-incubation for 30 min with Bjssu and 1 mg/mL Vf; and a Bjssu pretreated preparation (for 10 min) followed by 1 mg/mL Vf. Myographic recording was performed, and the contractile responses were recorded. The antimicrobial activity (minimum inhibitory concentration [MIC] and minimum bactericidal concentration [MBC]) was obtained for Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Enterococcus faecalis, using gentamicin and vancomycin as positive controls. Results: TLC analysis yielded several compounds from Vf, such as flavonoids (quercetin) and phenolic acids (chlorogenic acid). Bjssu completely blocked the contractile responses of PND preparations, while Vf preserved 97% (±10%) of the contractile responses when incubated with Bjssu. In the PND pretreated with Bjssu, Vf was able to inhibit the neuromuscular blockade progress. MIC and MBC of Vf ranged from 2.5 to 5.0 mg/mL for P. aeruginosa and S. aureus strains, while no antimicrobial activity was observed for E. coli and E. faecalis.Conclusions: The hydroalcoholic extract from Vf leaves was able to neutralize and decrease the in vitro neuromuscular blockade caused by Bjssu. However, it did not show significant antimicrobial activity against the tested bacteria. © 2014 Tribuiani et al.; licensee BioMed Central Ltd.Snakebite is a significant public health issue in tropical countries. In Brazil, some of the most common snake envenomations are from Bothrops. Bothrops bites trigger local and systemic effects including edema, pain, erythema, cyanosis, infections, and necrosis. Vellozia flavicans is a plant from the Brazilian "cerrado" (savanna) that is popularly used as an anti-inflammatory medicine. Since inflammation develops quickly after Bothrops bites, which can lead to infection, the aim of the present study was to observe possible anti-snake venom and antimicrobial activities of V. flavicans (Vf). The chromatographic profile of the main constituents from the Vf leaf hydroalcoholic extract was obtained by thin-layer chromatography (TLC). The anti-snake venom activity was measured by Vf's ability to neutralize the in vitro neuromuscular blockade caused by Bothrops jararacussu venom (Bjssu) in a mouse phrenic nerve-diaphragm model (PND). After a 20 min incubation, preparations of PND were added to Tyrode's solution (control); Vf (0.2, 0.5, 1, and 2 mg/mL); 40 μg/mL Bjssu; pre-incubation for 30 min with Bjssu and 1 mg/mL Vf; and a Bjssu pretreated preparation (for 10 min) followed by 1 mg/mL Vf. Myographic recording was performed, and the contractile responses were recorded. The antimicrobial activity (minimum inhibitory concentration [MIC] and minimum bactericidal concentration [MBC]) was obtained for Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Enterococcus faecalis, using gentamicin and vancomycin as positive controls. TLC analysis yielded several compounds from Vf, such as flavonoids (quercetin) and phenolic acids (chlorogenic acid). Bjssu completely blocked the contractile responses of PND preparations, while Vf preserved 97% (±10%) of the contractile responses when incubated with Bjssu. In the PND pretreated with Bjssu, Vf was able to inhibit the neuromuscular blockade progress. MIC and MBC of Vf ranged from 2.5 to 5.0 mg/mL for P. aeruginosa and S. aureus strains, while no antimicrobial activity was observed for E. coli and E. faecalis. The hydroalcoholic extract from Vf leaves was able to neutralize and decrease the in vitro neuromuscular blockade caused by Bjssu. However, it did not show significant antimicrobial activity against the tested bacteria14FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOFAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO2004/09705-8; 2007/53883-6; 2008/52643-4; 2008/11005-5; 2012/08271-0Neglected tropical diseases: Snakebite, , http://www.who.int/bloodproducts/animal_sera/Rabies.pdf?ua=1, WHO - World Health Organization(2009) Textos Básicos de Saúde (Cadernos de Atenção Básican. 22), , Health surveillance:zoonoses, Brasil. Ministério da SaúdeTeixeira, R., Forma grave do acidente por ofídios da sub-família Crotalinae (1979) An Acad Med Bahia, 2, pp. 109-135Vellard, J.A., Serpentes venenosas (1945) Terapêutica Clínica, pp. 265-273. , Buenos Aires: Libreria y Editorial 'El Ateneo, Cardini C, Beretervide JJAlves, E., (1956) Medicina de Urgência, pp. 1052-1055. , Rio de Janeiro: Livraria AtheneuBrazil, V., (1901) Do envenenamento ophidico e seu tratamento, pp. 31-55. , Colletanea dos trabalhos Instituto ButantanRodrigues-Simioni, L., Borgese, N., Ceccarelli, B., The effects of Bothrops jararacussu venom and its components on frog nerve-muscle preparation (1983) Neuroscience, 10, pp. 475-489Souza, C.D., Felfili, J.M., The utilization of medicinal plants in the region of Alto Paraíso of Goiás, GO, Brazil (2006) Acta Bot Bras, 20, pp. 133-142Stannard, B.L., (1995) Flora of the Pico das Almas: Chapada da Diamantina - Bahia, Brazil, pp. 43-78. , Great Britain: Whitstable Litho LtdBranco, A., Pinto, A.C., Braz Filho, R., Chemical constituents from Vellozia graminifolia (Velloziaceae) (2004) An Acad Bras Cienc, 76, pp. 505-518Harborne, J.B., Williams, C.A., Greenham, J., Eagles, J., Variations in the lipophilic and vacuola flavonoids of the genus Vellozia (1994) Phytochemistry, 35, pp. 1475-1480Williams, C.A., Harborne, J.B., Greenham, J., Eagles, J., Differences in flavonoids patterns between genera within the Velloziaceae (1994) Phytochemistry, 36, pp. 931-940Pinto, A.C., Scofield, T.C.V., Braz-Filho, R., Two new diterpenes with a rosane skeleton from Velloziaceae (1983) Tetrahedron Lett, 24, pp. 5043-5046Pinto, A.C., Queiroz, P.P.S., Garcez, W., Diterpenes from Vellozia bicolor (1991) J Braz Chem Soc, 2, pp. 25-30Pinto, A.C., Rezende, C.M., Antunes, O.A.C., Correia, C.R.D., Three isomeric diterpenes from Vellozia flavicans (1996) Phytochemistry, 42, pp. 767-769Peixoto, E.M., Pinchin, R., Pinto, A.C., Constituintes químicos de Vellozia piresiana (1979) Ciênc Cult, 32, pp. 125-127Barnes, R.A., Pereira, A.L., Scofield, T.C.V., Braz-Filho, R., Pinto, A.C., A new triterpene from Vellozia compacta (1984) Chem Pharm Bull, 32, pp. 3674-3677Dharmappa, K.K., Kumar, R.V., Nataraju, A., Mohamed, R., Shivaprasad, H.V., Vishwanath, B.S., Anti-inflammatory activity of oleanolic acid by inhibition of secretory phospholipase A2 (2009) Planta Med, 75, pp. 211-215Magalhães, A., Santos, G.B., Verdam, M.C., Fraporti, L., Malheiro, A., Lima, E.S., Dos-Santos, M.C., Inhibition of the inflammatory and coagulant action of Bothrops atrox venom by the plant species Marsypianthes chamaedrys (2011) J Ethnopharmacol, 134, pp. 82-88Sampaio, S.C., Sousa-e-Silva, M.C.C., Borelli, P., Curi, R., Cury, Y., Crotalus durissus terrificus snake venom regulates macrophage metabolism and function (2001) J Leukoc Biol, 70, pp. 551-558(2002) Portuguese Pharmacopoeia, , Lisboa: Infarmed Editors, Portugal, Portuguese Pharmacopoeia CommitteeHarborne, J.B., (1998) Phytochemical Methods: A Guide to Modern Techniques of Plants Analysis, , London: Chapman & HallCintra Francischinelli, M., Silva, M.G., Andréo Filho, N., Cintra, A.C.O., Leite, G.B., Cruz Höfling, M.A.D.A., Rodrigues Simioni, L., Oshima Franco, Y., Effects of commonly used solubilizing agents on a model nerve-muscle synapse (2008) Lat Am J Pharm, 27, pp. 721-726Siles Villaroel, M., Rolim Rosa, R., Zelante, F., Furlanetto, R.S., Padronização da avaliação da potência de antivenenos botrópicos, em camundongos (1978) Mem Inst Butantan, 42-43, pp. 325-336Bülbring, E., Observation on the isolated phrenic nerve diaphragm preparation of the rat (1946) Br J Pharmacol, 1, pp. 38-61Ferraz, M.C., Parrilha, L.A.C., Moraes, M.S.D., Amaral Filho, J., Cogo, J.C., Dos Santos, M.G., Franco, L.M., Oshima Franco, Y., The effect of lupane triterpenoids (Dipteryx alata Vogel) in the in vitro neuromuscular blockade and myotoxicity of two snake venoms (2012) Curr Org Chem, 16, pp. 2717-2723Puebla, P., Oshima-Franco, Y., Franco, L.M., Santos, M.G., Silva, R.V., Rubem-Mauro, L., Feliciano, A.S., Chemical constituents of the bark of Dipteryx alata Vogel, an active species against Bothrops jararacussu venom (2010) Molecules, 15, pp. 8193-8204Gottlieb, O., Kaplan, M.A., Das plantas medicinais aos fármacos naturais (1993) Cienc Hoje, 15, pp. 51-54Souza Brito, A.R.M., How to study the pharmacology of medicinal plants in underdeveloped countries (1996) J Ethnopharmacol, 54, pp. 131-138Martini, N.D., Katerere, D.R., Eloff, J.N., Biological activity of five antibacterial flavonoids from Combretum erythrophyllum (Combretaceae) (2004) J Ethnopharmacol, 93, pp. 207-212Rates, S.M.K., Plants as source of drugs (2001) Toxicon, 39, pp. 603-613Soares, A.M., Ticli, F.K., Marcussi, S., Lourenço, M.V., Januário, A.H., Sampaio, S.V., Giglio, J.R., Pereira, O.S., Medicinal plants with inhibitory properties against snake venoms (2005) Curr Med Chem, 12, pp. 2625-2641Mors, W.B., Do Nascimento, M.C., Pereira, B.M.R., Pereira, N.A., Plant natural products active against snake bite - the molecular approach (2000) Phytochemistry, 55, pp. 627-642Barbosa, A.M., Villaverde, A.B., Guimarães Souza, L., Ribeiro, W., Cogo, J.C., Zamuner, S.R., Effect of low-level laser therapy in the inflammatory response induced by Bothrops jararacussu snake venom (2008) Toxicon, 1 (51), pp. 1236-1244Oshima-Franco, Y., Hyslop, S., Cintra, A.C., Giglio, J.R., da Cruz-Höfling, M.A., Rodrigues-Simioni, L., Neutralizing capacity of commercial bothropic antivenom against Bothrops jararacussu venom and bothropstoxin-I. (2000) Muscle Nerve, 23, pp. 1832-1839Oshima Franco, Y., Rosa, L.J.R., Silva, G.A.A., Amaral Filho, J., Silva, M.G., Lopes, P.S., Cogo, J.C., Da Cruz Höfling, M.A., Antibothropic action of Camellia sinensis extract against the neuromuscular blockade by Bothrops jararacussu snake venom and its mais toxin, bothropstoxin-I (2012) Pharmacology, pp. 469-489. , Croatia: Intech, Gallelli LMilani Júnior, R., Jorge, M.T., de Campos, F.P., Martins, F.P., Bousso, A., Cardoso, J.L., Ribeiro, L.A., Warrell, D.A., Snake bites by the jararacuçu (Bothrops jararacussu): clinic pathological studies of 29 proven cases in São Paulo State (1997) Brazil. QJM, 90, pp. 323-334Petricevich, V.L., Teixeira, C.F.P., Tambourghi, D.V., Gutiérrez, J.M., Increments in serum cytokine and nitric oxide levels in mice injected with Bothrops asper and Bothrops jararaca snake venom (2000) Toxicon, 38, pp. 1253-1266(2007) Rabies and envenomings: a neglected public health issue, , http://www.who.int/bloodproducts/animal_sera/Rabies.pdf, Available from: WHO - World Health OrganizationMalomouzh, A.I., Mukhtarov, M.R., Nikolsky, E.E., Vyskocil, F., Lieberman, E.M., Urazaev, A.K., Glutamate regulation of non-quantal release of acetylcholine in the rat neuromuscular junction (2003) J Neurochem, 85, pp. 206-213Rubem Mauro, L., Rocha, D.S., Barcelos, C.C., Varca, G.H., Andréo Filho, N., Barberato Filho, S., Oshima Franco, Y., Phenobarbital pharmacological findings on the nerve-muscle basis (2009) Lat Am J Pharm, 28, pp. 211-218. , Vila MMDCCintra-Francischinelli, M., Silva, M.G., Andréo-Filho, N., Gerenutti, M., Cintra, A.C.O., Giglio, J.R., Leite, G.B., Oshima-Franco, Y., Antibothropic action of Casearia sylvestris Sw. (Flacourtiaceae) extracts (2008) Phytother Res, 22, pp. 784-790Camargo, T.M., Nazato, V.S., Silva, M.G., Cogo, J.C., Groppo, F.C., Oshima-Franco, Y., Bothrops jararacussu venom-induced neuromuscular blockade inhibited by Casearia gossypiosperma Briquet hydroalcoholic extract (2010) J Venom Anim Toxins incl Trop Dis, 16, pp. 432-441Nazato, V.S., Rubem Mauro, L., Vieira, N.A.G., Rocha Junior, D., Dos, S., Silva, M.G., Lopes, P.S., Oshima Franco, Y., vitro antiophidian properties of Dipteryx alata Vogel bark extracts (2010) Molecules, 15, pp. 5956-5970Melo, R.F., Farrapo, N.M., Rocha Junior, D.S., Silva, M.G., Cogo, J.C., Dal Belo, C.A., Rodrigues Simioni, L., Oshima Franco, Y., Antiophidian mechanisms of medicinal plants (2009) Flavonoids: Biosynthesis, Biological Effects and Dietary Sources, pp. 249-262. , New York: Nova Science Publishers, Keller RBFarrapo, N.M., Silva, G.A.A., Costa, K.N., Silva, M.G., Cogo, J.C., Dal Belo, C.A., Dos Santos, M.G., Oshima Franco, Y., Inhibition of Bothrops jararacussu venom activities by Plathymenia reticulata Benth extracts (2011) J Venom Res, 2, pp. 52-58Cos, P., Vlietinc, A.J., Berghe, D.V., Maes, L., Anti-infective potential of natural products: how to develop a stronger in vitro 'proof-of-concept' (2006) J Ethnopharmacol, 103, pp. 290-302Mishra, U.S., Mishra, A., Kumari, R., Murthy, P.N., Naik, B.S., Antibacterial activity of ethanol extract of Andrographis paniculata (2009) Indian J Pharm Sci, 71, pp. 436-438Premendran, S.J., Salwe, K.J., Pathak, S., Brahmane, R., Manimekalai, K., Anti-cobra venom activity of plant Andrographis paniculata and its comparison with polyvalent anti-snake venom (2011) J Nat Sci Biol Med, 2, pp. 198-204Mahadeswaraswamy, Y.H., Nagaraju, S., Girish, K.S., Kemparaju, K., Local tissue destruction and procoagulation properties of Echis carinatus venom: inhibition by Vitis vinifera seed methanol extract (2008) Phytother Res, 22, pp. 963-969Oliveira, D.A., Salvador, A.A., Smânia, A., Smânia, E.F., Maraschin, M., Ferreira, S.R., Antimicrobial activity and composition profile of grape (Vitis vinifera) pomace extracts obtained by supercritical fluids (2013) J Biotechnol, 164, pp. 423-43
Reduced pulmonary oxygen diffusion at 36 weeks of postmenstrual age in small-for-gestational-age preterm infants of less than 32 weeks without bronchopulmonary dysplasia
Background: Small-for-gestational-age (SGA) preterm infants are at increased risk of developing bronchopulmonary dysplasia (BPD). There is limited information on pulmonary oxygen diffusion of SGA preterm infants, particularly in those without BPD. Objective: To compare the pulmonary oxygen diffusion of SGA to that of appropriate-for-gestational-age (AGA) preterm infants without BPD. Study Design: Preterm infants with a gestational age (GA) between 24.0 and 31.6 weeks were studied. The oxygen saturation (SpO2), fraction to inspired oxygen (FiO2), and the SpO2 to FiO2 ratio (SFR) were compared between SGA and AGA infants. The association between SGA and SFR at 36 weeks was assessed using a multiple regression analysis. In the subgroup without BPD, SGA were match-paired for GA and gender with AGA infants. Results: We analyzed 1189 infants surviving at 36 weeks: 194 (16%) were SGA and 995 (84%) AGA. The incidence of BPD was significantly higher in SGA than AGA infants (32% vs. 13%; p =.000). Out of the 995 infants without BPD, 132 (13%) were SGA and 863 (87%) AGA. SGA was negatively associated with the SFR value at 36 weeks, independently from BPD. SGA infants without BPD had significantly higher (better) SFR at birth, but lower (worse) SpO2 and SFR and from 33 to 36 weeks than their matched AGA counterpart. At 36 weeks, median SpO2 and SFR values were 97.7 versus 98.4 (p =.006) and 465 versus 468 (p =.010) in match-paired SGA and AGA, respectively. Conclusion: Among preterm infants of less than 32 weeks and without BPD, SGA infants had a reduced pulmonary oxygen diffusion at 36 weeks in comparison with AGA infants
Detecting neurodevelopmental trajectories in congenital heart diseases with a machine-learning approach
We aimed to delineate the neuropsychological and psychopathological profiles of children with congenital heart disease (CHD) and look for associations with clinical parameters. We conducted a prospective observational study in children with CHD who underwent cardiac surgery within five years of age. At least 18\ua0months after cardiac surgery, we performed an extensive neuropsychological (intelligence, language, attention, executive function, memory, social skills) and psychopathological assessment, implementing a machine-learning approach for clustering and influencing variable classification. We examined 74 children (37 with CHD and 37 age-matched controls). Group comparisons have shown differences in many domains: intelligence, language, executive skills, and memory. From CHD questionnaires, we identified two clinical subtypes of psychopathological profiles: a small subgroup with high symptoms of psychopathology and a wider subgroup of patients with ADHD-like profiles. No associations with the considered clinical parameters were found. CHD patients are prone to high interindividual variability in neuropsychological and psychological outcomes, depending on many factors that are difficult to control and study. Unfortunately, these dysfunctions are under-recognized by clinicians. Given that brain maturation continues through childhood, providing a significant window for recovery, there is a need for a lifespan approach to optimize the outcome trajectory for patients with CHD
Effect of preoperative pulmonary hemodynamic and cardiopulmonary bypass on lung function in children with congenital heart disease
In children with congenital heart disease (CHD), pulmonary blood flow (Qp) contributes to alterations of pulmonary mechanics and gas exchange, while cardiopulmonary bypass (CPB) induces lung edema. We aimed to determine the effect of hemodynamics on lung function and lung epithelial lining fluid (ELF) biomarkers in biventricular CHD children undergoing CPB. CHD children were classified as high Qp (n = 43) and low Qp (n = 17), according to preoperative cardiac morphology and arterial oxygen saturation. We measured ELF surfactant protein B (SP-B) and myeloperoxidase activity (MPO) as indexes of lung inflammation and ELF albumin as index of alveolar capillary leak in tracheal aspirate (TA) samples collected before surgery and in 6 hourly intervals within 24 h after surgery. At the same time points, we recorded dynamic compliance and oxygenation index (OI). The same biomarkers were measured in TA samples collected from 16 infants with no cardiorespiratory diseases at the time of endotracheal intubation for elective surgery. Preoperative ELF biomarkers in CHD children were significantly increased than those found in controls. In the high Qp, ELF MPO and SP-B peaked 6 h after surgery and tended to decrease afterward, while they tended to increase within the first 24 h in the low Qp. ELF albumin peaked 6 h after surgery and decreased afterwards in both CHD groups. Dynamic compliance/kg and OI significantly improved after surgery only in the High Qp. Conclusion: In CHD children, lung mechanics, OI, and ELF biomarkers were significantly affected by CPB, according to the preoperative pulmonary hemodynamics.What is Known:• Congenital heart disease children, before cardiopulmonary run, exhibit changes in respiratory mechanics, gas exchange, and lung inflammatory biomarkers that are related to the preoperative pulmonary hemodynamics.• Cardiopulmonary bypass induces alteration of lung function and epithelial lining fluid biomarkers according to preoperative hemodynamics.What is New:• Our findings can help to identify children with congenital heart disease at high risk of postoperative lung injury who may benefit of tailored intensive care strategies, such as non-invasive ventilation techniques, fluid management, and anti-inflammatory drugs that can improve cardiopulmonary interaction in the perioperative period
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